Bloat Book

This was taken from http://www.showdog-magazine.com/medical/bloatbook.htm its a good resource but clearly consult your vet!

First Aid For Bloat
(Gastric Dilatation - Volvulous)
Prepared by:
Siefried Zahn D.V.M
Adapted from "Bloat in Large Dogs"
Published by Univelt, Inc. 1983
(ISBN 0-912183-00-4)
"The following first aid procedures have worked for me. However, I cannot be responsible for anyone misunderstanding or misusing these procedures. I highly recommend everyone discuss bloat first aid procedures with their personal veterinarians and follow their advice explicitly."


BLOAT KIT ITEMS

1. Stethescope
2. Gauze roll
3. Mouth gag
4. K.Y. Jelly
5. Stomach Tube
6. Antiseptic Swabs
7. Trochar
8. Scalpel Blade


CONTENTS
(Bloat Kit Instructions)

Foreword Page iii
I. Introduction Page 1
II. What is bloat and how do identify it? Page 1
III. How do I know what stage of bloat my dog is in? Page 3
IV. What sequence of steps should I take to save my dog's life? Page 3
V. When should the Emergency Procedures be applied to save the dog's life? Page 5
VI. First Aid Procedures:
A. Use of a stethescope Page 5
B. Determining the character of the pulse Page 7
C. Color of the gums Page 7
D. Stomach-tubing your dog Page 7
E. Trocharizing your dog Page 13
VII. Preventing bloat Page 17

1. Introduction:
It is not the purpose of this kit to substitute for the prompt professional treatment by a qualified veterinarian, but is instead designed to assure, in so far as possible, that your dog is not dead when you reach professional facilities. You must read these instructions carefully and understand them completely before you attempt any of the emergency procedures described. If you have questions, you should discuss them with your veterinarian and perhaps ask him to instruct you further in the application of the emergency procedures described in these instructions. Should he not want to be helpful to you in this regard, you may consider changing veterinarians, as ACUTE GASTRIC DILATION or BLOAT is frequently fatal before veterinary attention is possible, and no veterinarian can successfully apply his skills in saving an animal that is already dead. Para-vet Products cannot be responsible for the misuse of the items in this kit.


II. What is Bloat and how do I identify it?
Bloat is an acute disease that affects many breeds of dogs, but primarily affects large and giant breeds including Great Danes, Saint Bernards, Irish Wolfhounds, Irish Setters, German Shepards, and others. The symptoms consist of anxiety, complete disinterest in food, frequent attempts to vomit without regurgitating stomach contents but only froth, a rapidly distending abdomen, labored breathing, stilted gait and in extreme cases brick red, blue, grey or white gums, a rapid heart beat with a weak pulse, and finally, prostration. See Table 1.

Table 1 Stages of Bloat

Stage 1 Bloat: Immediately transport dog to veterinarian without applying first aid.

Symptoms:
1. Anxiety, restlessness and panting.
2. Retching saliva but no stomach contents every 10 to 20 minutes.
3. Moderately enlarged abdomen with a watermelon sound when thumped.


Stage II Bloat: If veterinary help is more than 10 minutes away apply emergency procedures as outlined in this pamphlet as needed.

Symptoms:
1. Severe restlessness with reluctance to lie down.
2. Panting continuously.
3. Gums brick red.
4. Vomiting is attempted frequently (every two or three minutes).
5. Heart rate 80 to 100.
6. Abdomen enlarged and tense; sounding hollow when thumped.


*Stage III Bloat: Apply emergency procedures immediately.

Symptoms:
1. Dog unable to rise or is wobbly or has a sawhorse stance.
2. Gums are blue or white.
3. Abdomen is greatly distended, often distending before your eyes.
4. Heart rate 120 or greater with little pulse.


*Note: Many dogs can be found in Stage III Bloat which is fatal in minutes, without apparently going through Stage l or Stage II

III. How do I determine what stage of bloat my dog is in?

Procedure:

1. Note symptoms and compare to Table 1
2. Note color of the gums.
3. Listen to the heart (resting heart rate)

a. 75 beats per minute (BPM) or below equals Stage I Bloat.

b. 75 BPM to 100 BPM equals Stage II Bloat.

c. 100 to 150 BPM+ equals Stage III Bloat.

* Note rapidity with which abdomen is distending.

IV. In what sequence of steps should I proceed to apply first aid to my dog?


Procedure:

1. Diagnose stage of bloat.

2. Call veterinary hospital and advise doctor of the symptoms and seek advice.

3. Pass stomach tube, if possible, using the procedure described and illustrated in Section VI-D.

4. Trocharize dog if stomach tubing is unsuccessful using the procedure described in Section VI-E.

V. When should the emergency procedure be applied to save the dog's life?

A. If you can reach your veterinarian within 30 minutes, and your dog is in Stage I Bloat, do not apply any first aid procedures but proceed to the hospital.
B. If you cannot reach your veterinarian within 30 minutes and your dog is in Stage II Bloat you should attempt to pass a stomach tube as described in Section VI-D, before you attempt to get to the hospital.
C. If you cannot reach your veterinarian within 10 minutes and your dog is in Stage III Bloat, first attempt to pass a stomach tube as described in Section VI-D and if this is not accomplished quickly, trocharize your dog immediately as described in Section VI-E.

VI. First Aid Procedures for Bloat (Use in sequence)

A. Use of the stethescope (practice on a normal dog).
The heart is best heard on the left side of your dog's chest just behind the elbow. The normal rhythm of your dog's heart is irregular at rest and consists of a double beat often described as "lub-dub". The normal heart rate for a large breed is 60 to 75 beats per minute and the heart beat is strong enough to be visible on the chest wall.

B. Character of the pulse.

To take the pulse of a dog, you must press your index and middle fingers inside the animal's hind leg just below where it joins the body. If you feel carefully, you will feel a cord-like structure at this location on the inside of the thigh bone, called the femoral artery, and you will be able to note the rate and strength of the pulse in this artery.

C. Color of gums

If the dog's gums are pink to red and when you press them firmly with your index finger and then let go, the color returns immediately, then your dog is normal or is only mildly affected with bloat. If however, the color is brick red, grey, blue, or white, and when you press the gums with your index finger the color returns slowly or not at all, then you have an emergency situation on your hands. If the other signs of bloat are present, you have no time to lose.

D. Stomach-tubing (two persons required)

If you have determined that your dog is in Stage II or III Bloat by following all the procedures, and you cannot reach your dog's doctor in a reasonable time, you must attempt to pass a stomach tube into your dog. Care must be exercised not to get yourself or the animal excessively excited.

Step 1

Place the mouth gag between the jaws as shown in Figure 3a, and take a length of gauze and tightly bind the dog's muzzle with the mouth gag in position.

Step 2

When the mouth is secure, take the stomach tube provided and lubricate the beveled end and insert it carefully into the dog's mouth. When it reaches the dog's throat, some resistance will be noted on the dog's part and reassurance must be given while the animal's head is held securely. (Figs. 3b, c and d)

Also at this point, as you push the tube deeper into the throat, you will notice the dog swallowing and the tube will enter the esophagus easily. If the dog does not swallow easily or the tube seems to be stuck, you must gently move it back and forth slightly until it passes easily into the esophagus. After the tube is in the dog's esophagus, you must take the flared end of the tube and place it in your own mouth and gently blow into it as you carefully advance it toward the stomach. This expands the esophagus and makes the tube pass more easily and with with less trauma, toward the stomach. In most cases, the tube will encounter an abrupt blockage as it reaches the stomach, due to either muscle spasms in the stomach valve or due to partial twisting of the stomach on its axis. At this point you may blow into the tube strongly while rotating the

Measure the stomach tube on the outside of the dog from the front of the mouth to the last rib to determine what length will reach the stomach without going too far, and mark the tube with a piece of black tape. Asterisks show where some resistance can be expected as you pass the tube to the stomach. Once the tube is in the stomach, foul-smelling gas and fluid will be expelled through the tube. Care must be taken not to push the stomach tube too far after it is inside of the stomach.

If you cannot pass the stomach tube after careful manipulation as described in the text, do not attempt to force it in.
A Black tape marker
B Last rib

tube in a clockwise direction, and it will often enter the stomach. If it still does not enter the stomach, continue to blow into the tube and carefully rotate it back and forth. You may have to rotate the tube as much as a full turn, although usually. a one-quarter to one-half turn is adequate. If this is unsuccessful after five minutes of careful manipulation it is probably not possible to pass a stomach tube. If the stomach tube does enter the stomach, you will feel a sudden movement of the tube forward and you must immediately remove the other end of the tube from your mouth and place it lower than the dog's body while keeping the dog's head low. Care must be exercised not to push the tube too far into the stomach or you may rupture the wall. At this point much gas will come through the tube followed by fluids. If the drainage of fluid is minimal or stops after only a short time, you should stand over the dog, facing the same direction as the dog, and grasp him firmly with locked wrists around the abdomen just behind the breast bone and squeeze firmly. Continue to attempt to remove fluids and gas for five to ten minutes and then remove the stomach tube carefully while firmly capping the flared end with your thumb as you slowly pull the tube out and proceed to your veterinarian.

E. Trocharization:

This procedure is to be used in extreme cases of Stage III Bloat, only after you have failed to pass a stomach tube. If you have reached this stage of the first aid procedure for bloat, you have a very short time to act to save the life of your dog. He will be wobbly or unable to stand, his abdomen will be very large and sound like a tightly strung drum when you tap it, his heart rate will be over 120 BPM and his gums will be blue or white and he will be gasping for air.


The stomach is normally located on the left side of the dog's abdomen under the last few ribs. In an extremely bloated animal, the stomach almost fills the entire abdomen.

Procedure:

Step 1

If you have a dog in Stage III Bloat, you must locate the last rib on the dog's left side and if possible shave a 2-inch square patch immediately behind the rib approximately midway between the animal's back-bone and breast-bone. (Fig. 4a)

Step 2

Swab the shaved area with the antiseptic swabs three times using a new swab for each cleaning. If you are not able to shave or clip the hair from the skin, you must do the best you can to clean the area very well.

Step 3

Take the scalpel blade provided and carefully remove it from its package and cut into the skin in a line parallel to the last rib and about one inch behind it. Incise the skin through its entire thickness and for a length of one-half to three-quarters of an inch in length. Do not cut into the muscle beneath the skin. Bleeding will be very minimal, and you need not be concerned that you are hurting the animal, as he is probably only marginally aware of what is going on around him. He probably will not even flinch.

Step 4

Remove the protective cap from the plastic trochar, thus exposing the sharp end of the instrument. (Fig. 4b)

Step 5

Press the sharp end of the trochar into the incized area firmly and then thrust it into the abdomen with a strong push. The abdominal wall may be surprisingly resistant to this and it may have to be repeated one or more times before it punctures through. When the instrument has entered the abdomen, it will also have entered the stomach, as in Stage III Bloat the stomach is tightly inflated against the abdominal wall.

Step 6

At this point, you must twist the trochar until the screw portion of the shaft has entered the puncture hole and the guard is tight against the skin.

Step 7

Remove the stylus portion of the trochar, taking care to stand to one side as the pressure will release itself dramatically, expelling forth gas and then fluid. After the pressure is relieved the animal's condition will improve rapidly and you may immediately proceed to the veterinarian ' s office. LEAVE TROCHAR IN PLACE!

Step 8

Keep the animal warm as he is suffering from shock.

Trocharization is a procedure that is life-saving when applied before it is too late and your veterinarian will be grateful that you have brought him a patient which has a good chance of recovery instead of a terminal case. If you follow all of the procedures in this outline after a thorough understanding of the information therein, you should not have any concern that you need stand helplessly by while your dog dies of bloat.

VII. Prevention of Bloat

There are several predisposing causes of ACUTE GASTRIC DILATION or BLOAT in dogs, and several things can be done to aid in the prevention of its occurrence.

A. Feed foods which have little or no vegetable protein, as these foods cause gas formation through fermentation.
B. Feed dry foods that do not expand when they are mixed with water.
C. Feed your dog two or three small meals a day instead of one large meal, or better yet keep food available free-choice so the animal does not gorge himself.
D. Do not allow large intakes of water immediately after a meal.
E. Do not allow vigorous exercise for two to three hours after the dog has eaten.


In spite of following these recommendations, your dog may still get bloat, so be alert for symptoms and react promptly and calmly if they do occur. If ever you are in doubt about whether you should apply the first aid procedures, you should seek professional advice if at all possible. If you cannot reach a professional, you must do the best you can from the information contained in this booklet.